Literature Review

Beyond the picket lines: Why nursing strikes signal a need for systemic solutions Healthcare Business Today; by Eric L. Race; 2/15/26 The recent nursing strikes in New York City are making headlines, but they represent something much larger than a single labor dispute. Across the country, healthcare workers are voicing concerns that go far beyond compensation. When nurses walk picket lines, their signs tell a more complex story:

First union contract ratified for UVM hospice workers ABC22/FOX44, Burlington, VT; Press Release; 2/10/26 UVM Home Health and Hospice workers have ratified their first union contract. The vote was 72-1 to ratify the contract, more than six months after employees first voted to form a union in June. They named their union “Hospice United.” ... According to AFT Vermont, which represents 11,000 workers in healthcare and higher education, the agreement will mean a 17% increase in wages over the two and half years of the contract, and also makes accommodations for the rest of UVM Home Health potentially choosing to unionize in the future.

Spreading the principles of palliative care to all corners Health Affairs; by Jessica Nutik Zitter; 2/2/26 My daughter Sasha is a first-year medical student. ... Most recently, she has been envisioning herself as a palliative care physician. She tells me it may be the only specialty that will allow her to practice her values. As a long-time palliative care physician who has acted as an evangelist for the specialty, I surprised myself with a reflexive response. “I’m not sure that’s the best choice for you,” I said. ... Something needs to change—for our patients and for ourselves. ... I propose several strategies ...

Another strike sends 31,000 Kaiser Permanente health care workers to picket lines AP, U.S. News, Oakland, CA; 1/27/26 An estimated 31,000 registered nurses and other front-line Kaiser Permanente health care workers launched an open-ended strike this week in California and Hawaii to demand better wages and staffing from the health care giant. The picketing that began Monday marked the second major walkout in recent months by employees represented by the United Nurses Associations of California/Union of Health Care Professionals. A five-day strike in October ended with negotiations resuming, but talks broke down in December. This week the union accused Kaiser of refusing to return to national bargaining discussions.

Meant to Be: Denise's journey into hospice nursing The McKenzie, Tennessee Banner; 1/27/26 When Denise lost her husband, Tony, to leukemia at only 39, her world shifted forever. She was 29. ... In her thirties, ... she enrolled in nursing school, determined to rebuild her own story, one chapter at a time. ...Then came a nursing hospice opportunity. ... For Denise, hospice nursing isn't about endings; it's about helping families find peace, honesty, dignity, and hope in the final chapter. She carries the responsibility with deep reverence. "We're the last chapter," she says softly. "And if that chapter ends poorly, a lot of it is on us." ... Denise's journey reminds us that sometimes the hardest heartbreaks lead us to the most meaningful callings. Editor's Note: [Full access to this may require a subscription.] What personal life experiences brought many of your clinicians to end-of-life care? You may be surpised how little you know about them; what brings meaning and purpose for them; how seeing their journeys inspires you in your leadership role.

Briana Kohlbrenner: End-of-life care is under threat - as demand for hospice grows, workers say staffing and pay must keep paceVTDigger, Vermont; commentary by Briana Kohlbrenner; 1/27/26 As demand for hospice grows, workers say staffing and pay must keep pace. University of Vermont Home Health and Hospice (UVMHHH) is at a crossroads. As Vermont’s population ages, the demand for hospice care is growing. ... We are asking for fair and transparent pay scales, safe staffing and equity within the UVM Health system. Though we wear the same logo on our badges, we are paid less than our counterparts in other parts of the UVM Health system. A new nurse starting at UVM Home Health and Hospice earns $6.72 less per hour than a new nurse at the UVM Medical Center.

The malady of delayed palliative care McKnights Long-Term Care News; by Avi Steinberg; 1/21/26 This article asserts that while nursing homes face increasing pressure to deliver value-based, goal-concordant care, palliative care—one of the most effective tools to achieve these aims—remains underused and introduced far too late. The problem is not a lack of evidence, but systemic barriers: delayed identification, misaligned payment models, and workforce shortages. Earlier integration of palliative care can reduce unnecessary hospitalizations, lower costs, and improve resident and family experience. Treating palliative care as a standard of care rather than a last resort is an operational necessity for long-term care.

How hospice social workers create everyday moments that matter Severna Park Voice, Severna Park, MD; by Chris Gooding, LCSW-C, social worker Hospice of the Chesapeake; 1/15/26  There are many moving stories about how a hospice social worker helped a patient get married or take that one last trip to the ocean. These are impactful, memory-making moments that go a long way to honor the patient’s final wishes while helping a family heal after they’re gone. But I’m not going to share those kinds of moments. I’m going to share moments like helping the patient make a phone call to an estranged family member - or giving them permission to not make that phone call. Counseling a daughter whose mother no longer knows who she is due to dementia. These are moments that matter, everyday moments, that are nurtured by a hospice social worker. 

1 in 3 NPs and PAs switch specialties at least once in career AMA; by Kevin B. O'Reilly; 1/12/26 More than one-third of both nurse practitioners (NPs) and physician assistants (PAs) said in surveys conducted on behalf of the AMA that they have switched the specialty in which they provide care at some point during their career. While most nurse practitioners and physician assistants are trained to practice primary care, overwhelming majorities said additional formal training to gain the knowledge, acumen and skills needed to help provide care in the new specialty area was rarely pursued.

Employee experience trends: What the data says about 2026 Perceptyx; by Zachary Warman, MS, Oliver Lee Bateman, PhD & Bradley Wilson, PhD; 1/16/26 Perceptyx research across 20 million employee survey responses reveals the largest shift in engagement drivers ever recorded: change management and confidence in senior leadership now rank as top drivers, while belonging and feeling valued dropped from their consistent top-two positions. With 4.6% unemployment and a "low-hire-low-fire" market, stable retention numbers may mask a workforce too paralyzed to pursue growth rather than one that's thriving. 

15K Nurses strike, disrupting care at 5 NYC hospitals Patch, New York City, NY; by Miranda Levingston; 1/12/26 Five private hospitals are without nearly 15,000 nurses, who are striking for higher wages and health care benefits, starting Monday. According to the New York State Nurses Association, the contract for the union expired on Dec. 31, and hospitals had until Jan. 12 to reach an agreement with the union. The nurse union said that, in addition to higher wages and health care benefits, the union is striking for improved pension plans and protection from workplace violence, highlighting the recent active shooter situation at Mount Sinai on East 100th Street in November.

New AMA survey spotlights top priorities, challenges in 2026 HCN - HealthCare News, Chicago, IL; by HCN Staff; 1/9/26 Physician organizations are preparing for a dynamic state legislative landscape this year with health policy changes poised to reshape coverage, oversight, care delivery, and public health across the health system, according to a new survey released by the American Medical Assoc. (AMA). The AMA’s survey of 64 medical societies, including all 50 state medical societies and the District of Columbia, spotlights the leading healthcare priorities and challenges set to define state-level legislative action in 2026. Top issues include scope of practice, Medicaid policy pressures, and physician workforce challenges.